ArticleThe Pan African medical journal2018
Virological failure on first-line antiretroviral therapy; associated factors and a pragmatic approach for switching to second line therapy-evidence from a prospective cohort study in rural South-Western Uganda, 2004-2011.
Article in The Pan African medical journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Alcohol Use and Antiretroviral Therapy Non-Adherence Among Adults Living with HIV/AIDS in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.AIDS and behavior · 2020Pooled it
- Second-line virologic failure and elevated bilirubin as a potential surrogate marker of ART adherence among people living with HIV in Eastern Uganda.AIDS research and therapy · 2026Article
- Magnitude and factors associated with virological failure among adults on first-line antiretroviral therapy in Dire Dawa, eastern Ethiopia: a retrospective chart review.BMC research notes · 2025Article
- The urgent need for newer drugs in routine HIV treatment in Africa: the case of Ghana.Frontiers in epidemiology · 2025Review
- Detectable Virological Load and Associated Factors among People Living with HIV on Antiretroviral Treatment: A Retrospective Study.Pathogens (Basel, Switzerland) · 2024Article
- Time to viral load suppression and its predictors among people living with HIV on antiretroviral therapy in Gebi Resu zone, Afar Region, Ethiopia, 2023.Frontiers in public health · 2024Article
- Second-line anti-retroviral treatment failure and its predictors among patients with HIV in Ethiopia: A systematic review and meta-analysis.PLOS global public health · 2024Article
- Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling-What Can We Learn About Its Factors?Infection and drug resistance · 2023Article
- The Influence of Age-Associated Comorbidities on Responses to Combination Antiretroviral Therapy Among People Living with HIV, at the ART Clinic of Jimma Medical Center, Ethiopia: A Hospital-Based Nested Case-Control Study.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Article
- Determinants and reasons for switching anti-retroviral regimen among HIV-infected youth in a large township of South Africa (2002-2019).AIDS research and therapy · 2022Article
- Participants Switching to Second-Line Antiretroviral Therapy with Susceptible Virus Display Inferior Adherence and Worse Outcomes: An Observational Analysis.AIDS patient care and STDs · 2021Observational
- Predictors of failure on second-line antiretroviral therapy with protease inhibitor mutations in Uganda.AIDS research and therapy · 2021Article
- Time Until Loss to Follow-Up, Incidence, and Predictors Among Adults Taking ART at Public Hospitals in Southern Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2021Article
- Association between social support and viral load in adults on highly active antiretroviral therapy - Witbank, South Africa.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2020Article
- Predictors of first-line antiretroviral therapy failure among adults and adolescents living with HIV/AIDS in a large prevention and treatment program in Nigeria.AIDS research and therapy · 2020Article
- Modeling Viral Suppression, Viral Rebound and State-Specific Duration of HIV Patients with CD4 Count Adjustment: Parametric Multistate Frailty Model Approach.Infectious diseases and therapy · 2020Article
- Alcohol use and viral suppression in HIV-positive Kenyan female sex workers on antiretroviral therapy.PloS one · 2020Article
- Time to viral load suppression and its associated factors in cohort of patients taking antiretroviral treatment in East Shewa zone, Oromiya, Ethiopia, 2018.BMC infectious diseases · 2019Article
- Reply to Suthar et al.The Journal of infectious diseases · 2019Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWe investigated factors affecting Virological failure (VF) on first line Antiretroviral Therapy (ART) and evaluated a pragmatic approach to switching to second line ART.
methodsBetween 2004 and 2011, we assessed adults taking ART. After 6 months or more on ART, participants with VL >1000 copies/ml or two successive VL > 400 copies/ml (Conventional VF) received intensified adherence counselling and continued on first-line ART for 6 more months, after which participants who still had VL > 1000 copies/ml (Pragmatic VF) were switched to second line ART. VF rates were calculated and predictors of failure were found by fitting logistic regression and Cox proportional hazards models.
resultsThe 316 participants accrued 1036 person years at risk (pyar), 84 (26.6%) had conventional VF (rate 8.6 per 100 pyar) of whom 28 (33.3%) had pragmatic VF (rate 2.7 per 100 pyar). Independent predictors of conventional VF were; alcohol consumption, (adjusted Hazard Ratio; aHR = 1.71, 95% CI 1.05-2.79, P = 0.03) and ART adherence: per 10% decrease in proportion of adherent visits, (aHR = 1.83, 95% CI 1.50-2.23; P < 0.001). Using reference age group < 30 years, among conventional failures, the adjusted odds ratio (aOR) of pragmatic failure for age group 30-39 years were 0.12, 95% CI 0.03-0.57, P = 0.02 and for age group > 40 years were 0.14, 95%CI 0.03-0.71, P = 0.02. Alcohol consumers had a threefold odds of pragmatic failure than non-alcohol consumers (aOR = 3.14, 95%CI 0.95-10.34, P = 0.06).
conclusionA pragmatic VF approach is essential to guide switching to second line ART. Patient tailored ART adherence counselling among young patients and alcohol users is recommended.
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